Provider Demographics
NPI:1528113933
Name:LENZ, DAN EARL (CRNA)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:EARL
Last Name:LENZ
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:5901 WESTOWN PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8207
Mailing Address - Country:US
Mailing Address - Phone:850-785-3185
Mailing Address - Fax:850-785-6233
Practice Address - Street 1:801 E 6TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3661
Practice Address - Country:US
Practice Address - Phone:850-785-3185
Practice Address - Fax:850-785-6233
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2019-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAD098315367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9232153OtherFL LIC NUMBER
P00272318OtherMEDICARE RAILROAD
FLG3856OtherFL BCBS
FLG3856OtherFL BCBS